Chemotherapy for Wilms tumour

Chemotherapy is the use of anticancer, or cytotoxic, drugs to destroy cancer cells. Most children with Wilms tumour will have chemotherapy. The healthcare team will consider your child’s personal needs to plan the drugs, doses and schedules of chemotherapy. Your child may also receive other treatments.

Chemotherapy is given for different reasons. Your child may have chemotherapy to:

shrink a tumour before surgery (called neoadjuvant chemotherapy)

destroy cancer cells left behind after surgery and reduce the risk of the cancer recurring (called adjuvant chemotherapy)

treat advanced cancer

Chemotherapy is usually a systemic therapy. This means that the drugs travel through the bloodstream to reach and destroy cancer cells all over the body, including those that may have broken away from the primary tumour. Drugs used to treat Wilms tumour are given by intravenous injection, usually through a special device called a central venous catheter. It allows safe delivery of the chemotherapy. The surgeon will typically place this device at the start of chemotherapy.

Chemotherapy drugs commonly used for Wilms tumour

The most common chemotherapy drugs used to treat Wilms tumour are:

vincristine (Oncovin)

dactinomycin (Cosmegen, actinomycin-D)

doxorubicin (Adriamycin)

cyclophosphamide (Cytoxan)

cisplatin (Platinol AQ)

carboplatin (Paraplatin, Paraplatin AQ)

etoposide (Vepesid)

A combination of chemotherapy drugs is more effective than any single drug. Some chemotherapy combinations used to treat Wilms tumour are:

vincristine and dactinomycin

vincristine, doxorubicin and dactinomycin

vincristine, doxorubicin, etoposide and cyclophosphamide

dactinomycin or carboplatin may be added to this combination

Cyclophosphamide can irritate the bladder. When this chemotherapy drug is used, mesna (Uromitexan) is also given to protect the bladder.

If Wilms tumour does not respond to drugs used in earlier treatments or if it recurs, other chemotherapy regimens may be given. These may be used in alternating sequence or given as high-dose chemotherapy, sometimes with a stem cell transplant. Some of the chemotherapy combinations used include:

vincristine, doxorubicin and cyclophosphamide

ifosfamide (Ifex), carboplatin and etoposide

cyclophosphamide and etoposide

carboplatin and etoposide

Information about specific cancer drugs

The following websites have information about specific drugs used to treat cancer in children.

Taking action against all cancers

The latest Canadian Cancer Statistics report found that of all newly diagnosed cancers in 2017, half are expected to be lung, colorectal, breast and prostate cancers. Learn what you can do to reduce the burden of cancer.